Epilepsy and epileptic syndrome


Epileptic status without attacks



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Epileptic status without attacks. Epileptic status without epilepsy is an epileptic status characterized by the status of abscesses and complex focal seizures. It's a little lighter. The status of epileptic seizures without seizures, in turn, is divided into 2 types: 1) the status of absence 2) the status of complex focal attacks.

It is known that absence last for 30 seconds. During absence, the patient loses consciousness for a few seconds, but resumes when he regains consciousness. If the abscesses are observed for 20 to 30 minutes in a row, the patient becomes numb, which means that the status of abscesses occurs. During the status of absence often develop sopor and somnolence, rarely coma. Emergency care in epileptic status As mentioned above, epileptic status with tonic-clonic seizures requires immediate medical attention. Emergency medical procedures

1. First of all, it is necessary to take the patient to a safe place, open his collar and provide him with fresh air. It is important to avoid harsh objects that can cause injury. Hands and feet that are shaking cannot be touched. At this point, the patient's arm or leg may hit the doctor hard, and both may be injured.

2. If the patient's head is turned in any direction and attacks are observed, the doctor should take it between the palms of the hands and gently hold it in this position. If the doctor does this correctly, the head will be turned back, the tongue will be stuck in the throat, the saliva will go into the airways, and the head will be injured by hitting the ground. Put something soft under your head. However, the use of force in these acts is strictly prohibited.

3. The patient is taken by ambulance to the nearest hospital and admitted to the intensive care unit. If the ambulance is equipped with the necessary medical equipment, all necessary resuscitation procedures will be performed on the road.

4. During attacks, foamy saliva often comes out of the patient's mouth. This saliva can pass into the patient's airways when he takes a deep breath. It's too dangerous! Therefore, the saliva should be wiped with a clean cloth or gauze. If possible, an airway should be provided. Because laryngospasm is also observed during the attack.

5. Do not put a spoon or other hard object in the patient's mouth. It's too dangerous and useless.

6. 2 ml (10 mg) of diazepam in saline of sodium chloride is administered intravenously. Diazepam can also be administered in 20 ml of 40% glucose.

The rate of administration to children and adults should not exceed 2-5mg per minute. Otherwise, the heartbeat or breathing will stop or your blood pressure will drop. In children, diazepam is administered in an amount of 0.25 mg per 1 kg of body weight. If the child weighs 20 kg, he is given 5 mg of diazepam. If the attacks do not stop within 10 to 15 minutes, diazepam is given intravenously in the same amount.

7. If the attacks reappear after the cessation of action of the administered drugs, add 50 mg (10 ml) of diazepam to 250-500 ml of saline or sodium chloride saline and infuse intravenously for several hours.

8. Sometimes the use of drugs is required if the attacks do not stop. Sodium or thiopental sodium is often used for this purpose. 10 ml of 20% sodium solution is injected very slowly, within 10 minutes. Sometimes it is enough to give 5 ml of this drug. Instead of sodium, 10 ml of a 1% solution of thiopental sodium can be slowly administered intravenously. The drug is then infused intravenously in an amount of 50-70 ml. Drugs often cause a drop in blood pressure, heart and respiratory failure. Therefore, monitoring of the patient's blood pressure, heart and respiratory function should be provided.

9. All necessary laboratory tests are performed at the beginning of these treatments. To do this, the amount of glucose and electrolytes (sodium, potassium, chlorine, calcium) in the blood and urine, the acid-base status of the blood is checked.

10. If a patient falls into a deep epileptic coma, general treatments are continued until he or she emerges from the coma. To do this, the patient is given diuretics, dexamethasone, antipyretic drugs, antibiotics. Prolonged epileptic status often results in metabolic acidosis. To eliminate it, sodium bicarbonate or other similar drugs are injected intravenously.

11. A patient with epileptic status or coma is transferred from the intensive care unit to the neurology department and treatment is continued there. If the epileptic status is resolved quickly and without complications, the patient can be sent home in 1-2 days. She is being monitored by a general practitioner.

Epileptologists admit that in epilepsy, attacks are more common in patients who lead a passive life. It is less common in patients with active mental and physical activity. Therefore, restricting patients, especially children and adolescents, from physical activity and schooling and discussing their illness in front of them as a family can lead to severe mental trauma. Such children develop melancholy behaviors and grow up mentally handicapped. But keep in mind that excessive mental and physical stress can increase the number of attacks. Severe stress is more likely to trigger attacks. The patient should not be allowed to work in life-threatening occupations, such as driving, firefighting, police, guarding, or rescue. It is also prohibited to work in areas where chemicals are present or in high-rise buildings, or in factories where there is a high risk of injury. Working at night is not possible at all. This is because sleep deprivation at night can lead to recurrence or increase in attacks.

Housework and other activities. When taking a shower, the patient should not close the door from the inside, should not take hot or very cold showers, should not go to the sauna, and should not stay in the bath for a long time. Bake in the oven, cook in large pots, and always be careful not to work with sharp objects. Physiotherapeutic treatments are also not possible. One or two full-time employees should be aware of the disease. You should also not go on long trips alone and stay alone in hotels. Relatives of the patient need to know how to provide emergency care during an epileptic attack. At the same time, the home should have the necessary medications for emergency care. For example, magnesium sulfate and others




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